University Hospital Leuven and KU Leuven, Leuven, Belgium.
Department of Hepatogastroenterology and Gastrointestinal Oncology, University Paris-cité (Paris Descartes), SIRIC CARPEM, Georges Pompidou European Hospital, AP-HP, Paris, France.
J Clin Oncol. 2023 May 10;41(14):2628-2637. doi: 10.1200/JCO.22.01693. Epub 2023 Feb 10.
The positive BEACON colorectal cancer (CRC) safety lead-in, evaluating encorafenib + cetuximab + binimetinib in previously treated patients with -mutated metastatic CRC (mCRC), prompted the design of the phase II ANCHOR CRC study (ClinicalTrails.gov identifier: NCT03693170). ANCHOR CRC aimed to evaluate efficacy, safety, and quality of life with first-line encorafenib + binimetinib + cetuximab in -mutated mCRC.
In this multicenter, open-label, single-arm study, patients with -mutated mCRC received oral encorafenib 300 mg once daily and binimetinib 45 mg twice daily in 28-day cycles, plus intravenous cetuximab 400 mg/m once on day 1 of cycle 1, then 250 mg/m once weekly for the first seven cycles, and 500 mg/m once on Days 1 and 15 from cycle 8 onward. The primary end point was locally assessed confirmed objective response rate (cORR), and secondary end points included centrally assessed cORR, progression-free survival, overall survival (OS), quality of life, and safety and tolerability.
Among 95 patients, the locally assessed cORR was 47.4% (95% CI, 37.0 to 57.9) with all partial responses. Since the lower limit of the 95% CI exceeded 30%, the primary end point was met. With a median follow-up duration of 20.1 months, the median progression-free survival on the basis of local assessments was 5.8 months and the median OS was 18.3 months. Treatment was well tolerated, with no unexpected toxicities. Using Patient Global Impression of Changes, substantial improvement in symptoms was consistently reported in ≥ 30% of patients from cycle 3 to cycle 10.
The ANCHOR CRC study showed that the scientifically driven combination of encorafenib + binimetinib + cetuximab was active in the first-line setting of -mutated mCRC with a manageable safety profile. Further first-line evaluation is ongoing (ClinicalTrails.gov identifier: NCT04607421).
在先前接受治疗的 - 突变转移性结直肠癌(mCRC)患者中,阳性 BEACON 结直肠癌安全性导入试验评估了恩考芬尼+西妥昔单抗+比尼替尼的疗效,这促使设计了 II 期 ANCHOR CRC 研究(ClinicalTrials.gov 标识符:NCT03693170)。ANCHOR CRC 的目的是评估一线恩考芬尼+比尼替尼+西妥昔单抗在 - 突变 mCRC 中的疗效、安全性和生活质量。
在这项多中心、开放标签、单臂研究中, - 突变 mCRC 患者接受口服恩考芬尼 300mg 每日一次和比尼替尼 45mg 每日两次,每 28 天为一个周期,在第 1 周期的第 1 天给予静脉注射西妥昔单抗 400mg/m1 一次,然后在第 1 周期的前 7 天每周给予西妥昔单抗 250mg/m1 一次,从第 8 周期开始,西妥昔单抗剂量为 500mg/m1,第 1 天和第 15 天各一次。主要终点是局部评估确认的客观缓解率(cORR),次要终点包括中心评估的 cORR、无进展生存期、总生存期(OS)、生活质量以及安全性和耐受性。
在 95 例患者中,局部评估的 cORR 为 47.4%(95%CI,37.0%至 57.9%),所有患者均为部分缓解。由于 95%CI 的下限超过 30%,达到了主要终点。中位随访时间为 20.1 个月,基于局部评估的中位无进展生存期为 5.8 个月,中位 OS 为 18.3 个月。治疗耐受性良好,无意外毒性。使用患者整体印象变化,从第 3 周期到第 10 周期,始终有≥30%的患者报告症状有显著改善。
ANCHOR CRC 研究表明,在 - 突变 mCRC 的一线治疗中,恩考芬尼+比尼替尼+西妥昔单抗的联合应用具有科学驱动性,且安全性可管理。正在进行进一步的一线评估(ClinicalTrials.gov 标识符:NCT04607421)。